Cervical immobilizing device

ABSTRACT

A cervical immobilizing device includes a pair of arms that can be folded to an upright position to engage and support a patient&#39;s head, an actuating device for folding the arms to the supporting position, and a locking device for locking the position of the arms in the folded supporting position. The actuating device is coupled to the outer ends of the arms for folding the arms to an upright position symmetrically and uniformly. In one embodiment, the actuator device is flexible member that passes around a guide to a position which can be gripped by the user. The locking device can be a cinching, ratcheting or clamping device, or a combination thereof, on the actuator device. In one embodiment, the folding arms include a coupling device for coupling the arms to a base in a sliding arrangement to enable the arms to slide along the base to a folded position. A blank is also disclosed that can be folded to form the cervical immobilizing device.

This application is a continuation application of U.S. application Ser.No. 09/427,749 filed on Oct. 27, 1999, now U.S. Pat. No. 6,398,747.

FIELD OF THE INVENTION

The present invention relates generally to a head and cervicalimmobilization device. More particularly, the invention is directed to acervical immobilization device that can be erected symmetrically tominimize movement of the head of an injured patient.

BACKGROUND OF THE INVENTION

During the transport of patients or accident victims that have sufferedcervical injuries, it is essential to immobilize the head and cervicalportions to prevent further injury. A variety of head and cervicalimmobilization devices have been used in the emergency medical industryfor many years. Several of these devices are designed to fold flatduring storage and can be erected when needed.

One type of head immobilizing device is designed to be attached to arigid backboard. Other devices include a rigid structural portion thatdo not require the use of a rigid backboard. Examples of this type ofdevice are disclosed generally in U.S. Pat. No. 4,034,748 to Winner,U.S. Pat. No. 4,211,218 to Kendrick and U.S. Pat. No. 4,594,999 toNesbit.

Another type of device is disclosed in U.S. Pat. No. 4,928,711 toWilliams. This device is intended to be attached to a rigid backboardfor immobilizing the head of an injured patient. The device includesflexible members that are bent independently to wrap around the sides ofthe head and secure to the base for locking the position of the members.The head supporting members are attached to the base by a hook and piletype fastening device.

Another form of cervical immobilization device is disclosed in U.S. Pat.No. 4,964,418 to Wilson. This device has a pair of collapsible membersfor conforming to the patient's head. Rigid support members are thenattached to a base by a hook and loop fastener for restraining thepatient's head and neck.

The above-noted devices can be effective in immobilizing a patient'shead and neck during transport of an injured patient. However, thesedevices have certain limitations and there is a continuing need in theindustry for improved head immobilizing devices.

SUMMARY OF THE INVENTION

The present invention is directed to a cervical immobilization device.More particularly, the invention is directed to a collapsible cervicalimmobilization device that is folded to an upright position to engagethe sides of a patient's head symmetrically during use.

Accordingly, a primary object of the invention is to provide a cervicalimmobilization device that is compact during storage and can be erectedto a supporting position when needed.

Another object of the invention is to provide a cervical immobilizationdevice that can be manufactured economically using inexpensive andreadily available materials.

A further object of the invention is to provide a head immobilizationdevice for attaching to a rigid backboard which can be folded to conformto a patient's head that is efficient and easy to use.

Another object of the invention is to provide a cervical immobilizingdevice that can be made from a folded blank.

Still another object of the invention is to provide a cervicalimmobilization device having an actuator member that enables headengaging arms to simultaneously and symmetrically engage a patient'shead when folded to an operating position to eliminate or reducemovement of the patient's head.

Another object of the invention is to provide a cervical immobilizationdevice having an actuator device that can be operated by the user withone hand to symmetrically engage both sides of the patients head toprevent twisting of the head and to support the patient's head duringtransport of the patient.

The objects and advantages of the invention are basically attained byproviding a cervical immobilization device comprising a base havingfirst and second ends, a first edge and a rear edge, and a cervicalimmobilizing member coupled to the base. The cervical immobilizingmember is movable from a first position to a second upright position forengaging a patient's head. The immobilizing member has a center portionattached to the base and a pair of movable arms for engaging thepatient's head when in the second upright position. Each of the armshave an inner edge coupled to the center portion by a pivotal couplingand an outer edge facing outwardly toward the respective end of thebase. An actuating device is coupled to each of the outer ends of theimmobilizing member. The actuating member is able to simultaneouslyslide the outer ends of the cervical immobilizing member from the firstposition toward the center portion to the upright position forsupporting the patient's head. In embodiments of the invention, thecenter portion is a flat panel attached to the base and the arms arecoupled to the center panel by fold lines.

The objects of the invention are further attained by providing acervical immobilizing device comprising a base having a first and asecond end, a front edge and a rear edge. The base has a first slotextending from the first end toward the center portion of the base and asecond slot extending from the second end toward the center portion ofthe base. A cervical immobilizing member having a center panel isattached to the center portion of the base. The immobilizing memberincludes a first arm having an inner end coupled to the first edge ofthe center panel and an outer end spaced from the inner end. A secondarm having an inner end is coupled to a second side of the center paneland has an outer end spaced from the inner end. Each of the arms includea coupling member for sliding engagement with a respective slot. Anactuating device is coupled to the first and second arms forsimultaneously and symmetrically sliding the outer ends of the first andsecond arms inwardly toward the center panel to fold each of the arms toa substantially V-shaped configuration for engaging and supporting apatient's head.

The objects of the invention are also attained by providing a blank forforming a cervical immobilizing device where the blank comprises a firstpanel having first and second longitudinal ends and a center panelhaving longitudinal ends. A first flap is coupled to the first end ofthe center panel by a first fold line and has a second fold linesubstantially parallel to the first fold line and spaced from the foldline to define an inner and an outer panel. A second flap is coupled tothe second end of the center panel by a first fold line. The secondpanel has a second fold line parallel to and spaced from the first lineto define an inner and outer panel. In certain embodiments of theinvention, a first tab is coupled to the outer panel of the first flapand a second tab is coupled to the outer panel of the second flap. Aconnecting panel is coupled to a longitudinal side of the center panelby a fold line. A second panel having longitudinal ends and first andsecond longitudinal side edges is coupled to the connecting panel by afold line along the first longitudinal side edge. The second panel hasat least one first aperture adjacent the first flap and at least onesecond aperture adjacent the second flap.

These and other objects of the invention will become apparent to one ofordinary skill in the art in view of the following detailed descriptionin combination with the annexed drawings, which form a part of thisoriginal disclosure.

BRIEF DESCRIPTION OF THE DRAWINGS

The following is a brief description of the drawings, in which:

FIG. 1 is a top plan view of a blank for forming the cervicalimmobilizing device in a first embodiment of the invention;

FIG. 2 is a perspective view of the blank of FIG. 1 in a partiallyfolded position;

FIG. 3 is a perspective view of the cervical immobilization deviceformed from the blank of FIG. 1;

FIG. 4 is a top view of the cervical immobilization device formed fromthe blank of FIG. 1;

FIG. 5 is a bottom view of the cervical immobilization device formedfrom the blank of FIG. 1;

FIG. 6 is a schematic side view of the actuating device and lockingarrangement of the cervical immobilization device of the embodiment ofFIGS. 1-5;

FIG. 7 is a perspective view of the cervical immobilization device in apartially erected position;

FIG. 8 is a partial cross-sectional view of the actuating member andsliding arrangement for the foldable arms as seen along line 8—8 of FIG.3;

FIG. 9 is a top view of the cervical immobilization device in a secondembodiment of the invention;

FIG. 10 is a top plan view of the actuator device for the cervicalimmobilization device of FIG. 9;

FIG. 11 is a top view of the cervical immobilization device of theembodiment of FIG. 9 showing the head supporting arms in the erectedposition;

FIG. 12 is a top plan view of a blank for forming a cervicalimmobilization device in a third embodiment of the invention;

FIG. 13 is a top view of the cervical immobilization device formed fromthe blank of FIG. 12;

FIG. 14 is a bottom view of the cervical immobilization device of FIG.13 showing the head engaging arms in the folded position;

FIG. 15 is a cross-sectional view showing the head engaging arms in thefolded position;

FIG. 16 is a top plan view of a blank for forming a cervicalimmobilization device in a further embodiment of the invention;

FIG. 17 is a top view of a cervical immobilization device formed fromthe blank of FIG. 16;

FIG. 18 is a cross-sectional view of the cervical immobilization deviceof FIG. 17 showing the head supporting arms in the folded position;

FIG. 19 is a top view of a blank in a further embodiment of theinvention; and

FIG. 20 is a top plan view of the cervical immobilization device madefrom the blank of FIG. 19.

DETAILED DESCRIPTION OF THE INVENTION

The present invention is directed to a cervical immobilizing device thatcan be folded from a generally flat position during storage to a foldedupright position for engaging the sides of the head of a patient. Thehead immobilizing device of the invention is suitable for use incombination with a rigid backboard and is generally attached to therigid backboard by an adhesive.

The invention is primarily directed to a foldable cervical immobilizingdevice that includes an actuator that is pushed or pulled by a user tofold two head-engaging arms from a collapsed, generally flat position toan upright, head engaging position to support each side of the patient'shead. The actuator is able to fold the arms in a substantiallysymmetrical fashion to the upright position to reduce or eliminatetwisting of the head and to uniformly support each side of the head. Byproviding the actuator, which is coupled to each of the head-engagingarms, each of the arms can be folded at the same time, thereby applyinga uniform pressure in opposite directions on each side of the head andprevent twisting of the neck or lateral movement of the head that couldotherwise occur if the arms were folded one at a time. The device can bemade from various materials having sufficient strength to support thehead of a patient. In the embodiments illustrated, the device is made ofa suitable cardboard material. In further embodiments, the device can bemade from plastic materials by injection molding, thermoforming orrotations molding techniques.

Referring to FIGS. 1-8, a first embodiment of the assembled cervicalimmobilizing device 10 and blank 22 are shown. As shown in FIGS. 3-5,the device 10 includes a first base panel 12 and a top panel 14. The toppanel 14 includes two opposing arms 16 that can be folded from a flatposition as shown in FIG. 3 to a folded upright position as shown inFIG. 7. An actuating device 20 is attached to each of the arms 16 sothat the arms 16 can be folded to an upright position substantiallysimultaneously and symmetrically. Folding the arms 16 symmetricallyenables the arms to simultaneously engage the two sides of the patient'shead to minimize movement of the head and spine while attempting tostabilize an injured patient. In further embodiments, the actuatordevice is able to move the arms to an upright position one at a time.For this purpose, two actuator devices can be used.

The cervical immobilizing device 10 of the invention is generally madefrom a suitable sheet material having sufficient strength to support apatient's head and that can be folded along fold lines or score lines toallow for simple construction. In embodiments of the invention, the headimmobilizing device is made of corrugated cardboard, although otherinexpensive sheet materials, such as plastic, can be used. In furtherembodiments, the device can be made from separate components that arecoupled together.

In embodiments of the invention, the cervical immobilizing device 10 ismade from the unitary cut blank 22 as shown in FIG. 1. In the embodimentof FIG. 1, the blank 22 includes a first panel 24 that forms the toppanel 14 of the assembled device 10, a second panel 26 that forms thebase 12 of the device 10 and a third panel 28. The first panel 24 has asubstantially rectangular shape with outer ends 30 and 32. The firstpanel 24 is defined by a center panel 34 and first and second flaps 36and 38. The first flap 36 is coupled to a side edge of the center panel34 by a fold line 40. The first flap 36 includes an intermediate foldline 41 extending parallel to the first fold line 40 to divide the flap36 into an inner panel 42 and an outer panel 44. A fold line 46 spacedfrom the end 30 of the first flap 36 forms an end portion 48.

The outer panel 44 includes cut lines 50 to define a tab 52. The tab 52includes a neck portion 54 coupled to the outer panel 44 along the foldline 46. A head portion 56 is coupled to the neck portion 54 by a foldline 58. A second fold line 60 spaced from the fold line 58 is alsoprovided on the neck portion 54 for folding the head portion withrespect to the neck portion 54 as discussed hereinafter in greaterdetail. In preferred embodiments, the head portion 56 has a widthgreater than the width of the neck portion 54. An aperture 61 isprovided in the head portion 56 and an aperture 62 is provided in theneck portion 54 as shown. The second flap 38 is substantially the sameas the first flap 36 so that identical elements are identified by thesame reference number for simplicity.

The center panel 34 has a first side edge 64 with a coupling tab 66coupled to the center panel along a fold line 68. A second fold line 70defines an intermediate portion 71 and a head portion 72. The headportion 72 includes end notches 74 for engaging a slot.

The center panel 34 includes a second edge 76 attached to a couplingpanel 78 along a fold line 80. In the embodiment illustrated, thecoupling panel 78 has a length substantially equal to the length of thecenter panel 34. The second panel 26 is coupled to the coupling panel 78along a fold line 82.

The second panel 26 has a length a width substantially equal to thelength and width of the first panel and includes two substantiallyT-shaped slots 84. Each slot 84 has a longitudinal dimension extendingparallel to a longitudinal dimension of the second panel 26. The slot 84has a width at least equal to the width of the neck portion 54 of thetab 52 and less than the width of the head portion 56. At the outermostend of the slot 84, leg portions 85 defining the T-shape are provided todefine a width at least equal to the width of the head portion 56. In afurther embodiment, a single slot can be formed having a length toaccommodate each of the tabs 52.

A second connecting panel 86 is coupled to the second panel 26 by a foldline 88 and is positioned opposite the coupling panel 78. Connectingpanel 86 includes a longitudinal slot 90 dimensioned to receive thecoupling tab 66 when the blank 22 is folded to form the immobilizingdevice 10. The third panel 28 is coupled to the connecting panel 86along a fold line 92.

The third panel 28 has a longitudinal dimension substantially equal tothe longitudinal dimension of the first and second panels. Side edges 94of the third panel 28 extend perpendicular to a rear edge 95 and have adimension substantially equal to the width of the second panel 26. Inthe embodiment illustrated, front edges 96 are angled with respect tothe side edges 94 to converge at a leading edge 98. Two longitudinalslots 100 are cut in the third panel 28 and have a length substantiallyequal to the slots 84. The slots 100 have a width at least as wide asthe width of the head 56 of tab 52 so that the head 56 can slide freelyalong the length of the slot 100. Alternatively, a single slot can beformed to receive the head 56 of each tab 52. An aperture 102 is cut inthe third panel 28 proximate the leading edge 98. A slit 104 extendsfrom the aperture 102 toward the leading edge 98.

As shown in FIG. 1, an end panel 106 is coupled to the leading edge 98of the third panel 28 along a fold line 108. The end panel 106 has awidth substantially equal to the length of the leading edge 98 andparallel sides 110 extending perpendicular to the edge 98. An elongatedslot 112 extends from an outer end 114 parallel to the sides 110 and isgenerally aligned with the aperture 102. The slot 112 includes sideedges 116 that are substantially straight and terminate in a curved,convex portion 118.

As shown in FIG. 2, the immobilizing device 10 is assembled by foldingthe first panel 24 along fold lines 80 and 82 onto the second panel 26in the direction of arrow 120 and the tab 66 is inserted into the slot90. The second panel 26 is folded along fold lines 88 and 92 onto thethird panel 28 in the direction of arrow 122. The end panel 106 isfolded along fold line 108 onto the third panel 28 and secured in placeby a suitable adhesive or fastener. The second panel 26 is secured tothe panel 106 by an adhesive. For purposes of illustration, the tabs 52are shown folded upwardly from the plane of the first panel 24. Duringassembly of the immobilizing device 10, the tabs 52 are foldeddownwardly and inserted through the slots 84 so that the head portion 56is on the opposite side of the second panel 26 from the first panel 24.The slots 84 and 100 are superimposed so that the head 56 of tab 52 isable to slide.

As shown in FIG. 3, the assembled immobilizing device 10 includes thebase 12 formed by the second panel 26 and a top panel 14 formed by thefirst panel 24. The flaps 36 and 38 of the blank 22 form the foldingarms 16. The tab 52 is folded along the fold lines 58 and 60 so that thetab 52 couples the arms 16 to the base 12 in a sliding manner. In thisembodiment, the actuating member 20 is a flexible cord or string. Eachend of the cord passes through the apertures 60 and 61 of a respectivetab 52. The end panel 106 forms a guide on the third panel 28 for thecord 20. As shown in FIG. 4, the cord passes between the arms 16 and thebase 12 and around the convex portions 118 of panel 106 and along theopen slot 112. As shown schematically in FIG. 6, the end of the cord 20passes downwardly through the aperture 102 in the third panel 28 to forma loop 124. The remaining portion of the cord 20 that is not passedthrough the aperture 102 is pulled through the loop 124 to form a secondloop 126. A fastener 127 can be attached to the cord to secure the twosections of the cord together.

The immobilizing device 10 is generally intended to be used incombination with a rigid backboard (not shown). For this purpose, adouble-faced adhesive strip 128 is provided on the bottom face of thethird panel 28 along each edge as shown in FIGS. 4 and 5. A releaselayer 130 having a tab 132 extending outwardly from the top edge of thedevice covers the adhesive strip 128. The immobilizing device 10 ispositioned on a rigid board or other substrate and the release layer 130is pulled to separate the release layer from the adhesive strip andexpose the adhesive, whereby the device can be attached to the board.

In a preferred embodiment, the release layer 130 has a length longerthan the length of the adhesive strip 128. The tab 132 is folded along afold line 133, generally at about a 45° angle, to extend perpendicularto the longitudinal dimension of the adhesive strip. The release sheetis removed by pulling in a direction generally perpendicular to theadhesive strip, which peels the release layer from the adhesive.

In use, the immobilizing device is placed under the head of a patientwith the center panel 34 positioned directly below the patient's head.The center panel 34 is generally dimensioned to accommodate the head ofa patient. The actuating device 20 is pulled in the direction of arrow129 of FIG. 7 to apply a tension to the ends of the cord coupled to thetabs 52. Pulling on the actuating device 20 in a preferred embodimentapplies a simultaneous and symmetrical force to the tabs 52 which pullsthe outer ends of the arms 16 inwardly toward the center panel 32 in thedirection of arrows 131. As the outer ends of the arms 16 are drawntoward the center panel 34, the arms 16 fold along the fold lines 40 and46, whereby the arms 16 assume a folded, upright, substantially invertedV-shaped configuration as shown in FIG. 7. The inner panels 42preferably simultaneously contact the opposite sides of the patient'shead with substantially uniform pressure and tension to eliminate orreduce movement of the patient's head during the folding of the arms 16.Alternatively, the actuating device 20 can be arranged to apply anon-uniform force against each side of the patient's head as needed andto separately move the arms from the flat position to the folded uprightposition. For example, the length of cord attached to each tab can bepulled separately to separately raise each arm to the folded position.In still further embodiments, two separate actuator devices can beincluded to selectively move the arms to the upright position at adesired time.

Once the arms 16 are folded to the desired upright position, theposition of the arms is locked by pulling on the cord 20 to tighten thefirst loop 124 around the cord and to pull the cord 20 into the slit104. The slit 104 is sufficiently thin to frictionally grip the cord 20.The loop arrangement of the cord 20 enables the cord to be cinched andheld in a fixed position and to provide infinite adjustment of theposition of the arms 16 with respect to the base 12. The inner panels 42are preferably able to bend slightly to conform to the shape of thepatient's head as the cord is pulled and support the user's head bypreventing movement and preventing further injury. A plurality of foldlines (not shown) can be provided on the inner panels 42 to allow theinner panels to fold and conform to the patient's head. The patient canbe removed from the device 10 by loosening the loop 124, therebyloosening the cord and allowing the arms 16 to be unfolded and movedaway from the patient's head. In actual use, an adhesive backed tape orstrap is generally attached to the arms 16 and passed over the foreheadof the patient to secure the patient's head to the immobilizing device10.

It will be appreciated that the cervical immobilizing device 10 can bemade from a folded blank having an arrangement of panels different fromthe embodiment of FIG. 1. In further embodiments, the panels can beseparate elements that are assembled and secured together by adhesivesor other fasteners. Other locking devices can be used to lock theactuator device in a fixed position and retain the arms in the uprightposition. For example, a post or button-like device can be attached tothe upper surface of the immobilizing device so that a cord can bewrapped around the post to secure the cord in place.

A second embodiment of the cervical immobilizing device 133 of theinvention is illustrated in FIGS. 9-11 and is similar to theimmobilizing device 10 of the embodiment of FIG. 1 except for theactuating device 134. The cervical immobilizing device 133 of thisembodiment is made from a blank substantially the same as the blank 22of FIG. 1. Accordingly, identical components and parts of theimmobilizing device 133 are identified by the same reference number. Inthis embodiment, the actuating device 134 includes a body portion 136having a plurality of ratcheting teeth 138 on opposite sides of the bodyportion 136. A gripping end 140 is provided in the form of a loop. Inthis embodiment, a slit 142 is provided along the fold line 108 having alength substantially equal to the width of the body portion 136 and lessthan the outer dimension of the teeth 138. A transverse slit 144 is cutperpendicular to the slit 142 to allow the loop 140 to be inserted andpositioned in the slit 142. In the embodiment illustrated, thetransverse slit 144 is formed in panel 106 so that the slit 144 appearson the top portion of the device 133. Alternatively, the slit 144 can beformed in the panel 28 to appear on the bottom of the device 133. Asshown in the cut-away view of FIG. 9 and the top view of FIG. 8, theactuating device 134 includes two flexible leg members 146 extendingfrom the body portion 136 to the tabs 52. The flexible legs 146 includean enlarged T-shaped head 148 for passing through the apertures 61 and62 and coupling with the tab 52.

The immobilizing device 133 of the embodiment of FIGS. 9-11 is used in asimilar manner as the embodiment of FIGS. 1-8. Basically, theimmobilizing device 133 is fixed to a rigid backboard and the patient'shead is placed on the center panel 34 with the actuating device 134extending away from the patient's body. The loop 140 is pulled away fromthe immobilizing device 133 so that the flexible legs 146 of theactuating device 134 pull the ends of the arms 16 toward the centerpanel 34 and fold the arms 16 along the fold lines 40 and 41 to theupright position. The actuating device 134 is pulled until the teeth 138pass through the slit 142 so that the teeth engage the sides of the slit142 to lock the actuating device 134 in a fixed position, therebylocking the arms 16 in a folded, upright position. As can be seen inFIG. 11, the teeth 138 form a one-way ratchet mechanism with the slit142 for adjusting and locking the position of the arms 16.

FIGS. 12-15 illustrate a third embodiment of the invention. In thisembodiment, the immobilizing device 150 is similar to the device of FIG.1 so that similar elements are identified by the same reference number.FIG. 12 shows a blank 151 for forming the immobilizing device 150 andincludes panels 24, 26, 28 and 106 that are substantially the same asthe previous embodiments. This embodiment differs primarily from theembodiment of FIG. 1 in that the outer panels 44 include a cut portion50 to form tabs 152 having a substantially trapezoidal-shaped head 154.As shown, the head 154 includes angled sides 156 which converge towardthe neck portion 158.

The slots 100 in panel 26 include a plurality of teeth 160 extendinginwardly from each side of the slot. The teeth 160 are dimensioned tointerlock with the angled sides 156 of the tabs 152. As shown, the teethhave a first face 161 angled in the direction of the outer edges and asecond face 163 extending substantially perpendicular to the side edgeof the slot 100. Alternatively, a single slot can be formed toaccommodate the tabs 152. A hole 162 is punched along the fold line 108for the actuating device 164.

FIG. 13 is a top view of the assembled immobilization device 150. Asshown, the actuating device 164 is a flexible member such as a string orcord attached to each coupling tab 152 and passes through the hole 162around each of the convex surfaces 118. The actuating device 164 ispulled outwardly from the immobilizing device 150 which pulls the tabs152 and the outer ends of the arms 16 toward the center panel 34 as inthe previous embodiments to the upright folded position as shown in FIG.15. As shown in FIG. 14, pulling the actuating device 164 pulls the tabs152 along the slot 100 where the sides 156 engage the teeth 160 in aratcheting motion. The edges 156 engage the teeth 160 to lock the tabs152 in a fixed position. As shown in FIG. 15, the teeth 160 allow thetabs to slide or ratchet in the direction of center panel 34 and preventthe tabs 152 from sliding back to the original position. In furtherembodiments, the tabs 152 can be moved manually by the user by pushinginwardly on each tab until the teeth 160 engage the edges of the tab tolock the tabs in position. In this embodiment, the actuator device canbe eliminated where the tabs are to be moved manually.

Referring to FIGS. 16-18, a further embodiment of the invention isillustrated. This embodiment is similar to the previous embodiments,except that the cervical immobilizing device 170 is formed from twolayers of material superimposed on one another. The cervicalimmobilizing device 170 is formed from a blank 172 as shown in FIG. 16.The blank 170 includes a first panel 174 and a second panel 176. Thefirst panel 174 includes an outer portion 178 extending the length ofthe first panel in the longitudinal direction and is integrally formedwith a center panel 180. The center panel 180 has a longitudinal edge182 coupled to a coupling panel 184 by a fold line 186. The center panel180 also has transverse side edges 189 coupled to identical flaps 188 byfold lines 190. Each of the flaps 188 have a longitudinal dimensionextending to the edge of the outer portion 178. The flaps 188 include acenter fold line 192 to define an inner panel 194 and an outer panel196. A coupling tab 198 extends from the edge 200 of the outer panel196. A pair of apertures 202 are formed in the outer panel 196 adjacentthe coupling tab 198.

The center panel 180 includes a center aperture 204 having a generallytriangular shape. The aperture 204 has a first edge 206 extending in thelongitudinal direction of the first panel 174 and has a length slightlygreater than the width of the center panel 180 so that the aperture 204extends into each inner panel 194. A second edge 208 and a third edge210 extend from the first edge 206 and converge to an apex 212. Thesecond and third edges have a generally convex shape as shown in FIG.16. As shown, each of the side edges join an adjacent side edge at agenerally curved intersection.

The coupling panel 184 is coupled to the second panel 176 by a fold line214. The second panel 176 has an overall dimension and shapesubstantially the same as the first panel 174. As shown in FIG. 16, aplurality of spaced-apart slots 216 are formed in the second panelextending in a generally transverse direction with respect to thelongitudinal dimension of the second panel 176. The slots 116 have alength and width sufficient for receiving the coupling tab 198. Acentral aperture 218 is provided in the second panel 176 proximate theouter longitudinal edge 220 of the second panel 176.

The cervical immobilizing device 170 as shown in FIG. 17 is formed byfolding the first panel 176 along fold lines 186 and 214 so that thefirst and second panels are superimposed on one another. The outerportion 178 of the first panel 174 and the center panel 180 arepreferably attached to the second panel 176 by a suitable adhesive orfastening device. An actuating device 222 is coupled to the outer endsof the flaps 188 adjacent the coupling tabs 198. The actuating device222 extends between the first and second panels toward the centeraperture 204 and is guided along the convex edges 208 and 210 to theaperture 218. The actuating device 222 extends through the aperture 218and extends beyond the edge 220 of the panels 174 and 176 a sufficientdistance to be gripped by a user. In the embodiment illustrated, theactuating device 222 is a flexible cord having each end attached to arespective end of the first panel. A suitable clamping device 224 isprovided on the actuating device 222 to limit the movement of theactuating device through the aperture 218. The clamping device 224 canbe a spring biased clamp capable of gripping the actuating device andpreventing the actuating device from retracting in the immobilizingdevice 170.

A top panel 226 is positioned over the center panel 180 to cover theaperture 204. Preferably, the top panel 226 is dimensioned to completelycover the center panel 180 and is attached thereto by a suitableadhesive or other fastening device. Generally, the top panel 226 is aflexible cushioning foam for supporting a patient's head, although othermaterials can be used.

The cervical immobilizing device 170 is used in a similar manner to theprevious embodiments. As in the previous embodiments, the device 170 isattached to a rigid backboard by adhesive strips 228 on the bottom sideof the second panel 176. A patient's head is placed on the top panel 226with the actuating device 222 extending away from the patient's body.The actuating device 222 is pulled away from the center panel 180 whichdraws the outer edges of the flaps 188 inwardly toward the center panel.As the actuating device pulls the outer edges of the flaps 188 towardthe center panel, the flaps 188 fold along the fold lines 190 and 192 toan upright position as shown in FIG. 18.

The actuating device 222 pulls the outer edges of the flaps 188 to anupright position in a symmetrical fashion to avoid or reduce movement ofthe patient's head during the use of the device. The coupling tabs 198slide along the second panel 176 and are received in one of the slots216 to lock the outer panel 196 in a fixed position. The different slots216 allow selective adjustment of the position of the coupling tabs 198to accommodate different patients. Although four slots are shown foreach of the coupling tabs 198, it will be appreciated that additional orfewer slots can be used as needed to accommodate different sizepatients.

The actuator device 222 is pulled to a position where the inner panels194 contact the patient's head and conforms to the shape of thepatient's head and the coupling tab 198 is positioned in the appropriateslot 216. The suitable strap or tape is then placed across the foreheadof the patient and attached to the immobilizing device 170 to secure thepatient's head in a fixed position. The clamping device 224 can be slidalong the actuating device 222 until it engages the edge of the device170 to prevent the actuating device 222 from retracting into the deviceand allowing the flaps 188 to unfold or return to their originalposition. In further embodiments, the arms 188 can be moved individuallyby manually pushing the arms inwardly to the folded upright position andlocked in place by inserting the tabs 198 into a selected slot 216. Inthis embodiment, the actuator device can be eliminated.

In a further embodiment, the cervical immobilizing device 240 is formedfrom two superimposed panels 242 and 244 as shown in FIGS. 19 and 20.The immobilizing device 240 can be formed from separate panels that arebonded together. In the illustrated embodiment, the device 240 is madefrom a fold blank 246 of cardboard or other material as shown in FIG.19. The blank 240 includes the first panel 242 and the second panel 244coupled together along a fold line 248. The first panel 242 and thesecond panel 244 are substantially the same shape and size.

The first panel 242 includes a center panel 250 and cut lines 252 toform a top portion 254 and arms 256. Each arm 256 is coupled to the sideedges of the center panel 250 by a fold line 258. The arms 256 includean intermediate fold line 260 to define an inner panel 262 and outerpanel 264. An aperture 266 is formed in each of the outer panels 264adjacent the outermost edges.

The top portion 254 of panel 242 has a longitudinal dimension equal tothe combined longitudinal dimension of the arms 256 and the center panel250. The top portion has a generally truncated triangular shape withside edges 268 converging toward the fold line 248. A slit 278 is formedalong the fold line 248. The center panel 250 includes a generallyT-shaped aperture 270 having a base portion 272 extending in thedirection of the fold line 248 and a pair of arm portions 274. As shownin FIG. 19, arm portions 274 have a curved portion 276. The arm portions274 have a length to extend a slight distance past the fold lines 258into the inner panels 262.

The cervical immobilizing device 240 is formed by folding the blank 246along the fold line 248 and attaching the panels 242 and 244 together.Generally, the top portion 254 and the center panel 250 are attached tothe second panel 244 by a suitable adhesive. The arms 256, as in theprevious embodiments, are movable with respect to the second panel 244.

An actuating device 280 is attached to each end of the arms by insertingthe free end through the apertures 266. The actuator device 280 issubstantially the same as in the previous embodiments so identicalelements are identified by the same reference numbers. The end of theactuator fed through a transverse slit 282 in the second panel 244 andpositioned in the longitudinal slit as shown in FIG. 20. The flexiblelegs of the actuator device extend around the curved portions 276 of theaperture 270, which serve as a guide for the flexible legs. A flexiblecushion or pad 284 is generally attached to the center panel to coverthe aperture in the center panel.

The cervical immobilizing device 240 is used in a similar manner as theprevious embodiments. The actuator device 280 is pulled by the user sothat the arms 256 are moved to a folded upright position as in theprevious embodiments. The teeth of the actuator device are pulledthrough the slit 282 to engage the walls of the slit 278 and lock thearms in the folded position.

Several embodiments have been chosen to illustrate the invention. Itwill be appreciated by those skilled in the art that various othermodifications and embodiments can be constructed without departing fromthe various features of the invention. For example, the actuating devicein each of the illustrated embodiments is a flexible member that ispulled away from the device to pull the outer ends of the support armsof the device toward the patient's head to a locked position. In furtherembodiments, the actuator device can be an assembly of flexible or rigidcomponents or levers that can be either pushed or pulled to draw thearms from the flat position to the upright position for engaging thepatient's head. In a further embodiment, the actuator device can includea pair of rigid levers extending from the outer ends of the arms andcoupled together by a pivot mechanism at the center of the device. Anarm or lever can be attached to the pivot device that can be pulled orpushed causing a scissor-like action of the rigid members to pull theouter ends of the flaps toward the center of the device. In a similarmanner, the locking device can be other arrangements for fixing theposition of the arms in the folded position during use.

1. A cervical immobilizing device, comprising: a base having first andsecond ends, a front edge and a rear edge; a cervical immobilizingmember coupled to said base and being foldable from a first position toa second folded position for engaging a patient's head, said cervicalimmobilizing member including a center portion attached to said base andincluding a pair of movable arms for engaging said patient's head whenin said second position, said arms having a first pivotal coupling forcoupling an inner edge of said arms to said center portion and an outeredge facing outwardly toward a respective end of said base; and anactuating device coupled to each of said outer edges of said arms, saidactuating device being disposed for sliding said outer edges of saidarms from said first position toward said center portion to said secondfolded position for supporting said patient's head.
 2. The immobilizingdevice of claim 1, wherein said center portion comprises a center paneland each said foldable arms include a second pivotal coupling spacedfrom said first pivotal coupling to define an inner panel adjacent saidcenter panel and an outer panel.
 3. The immobilizing device of claim 2,wherein said cervical immobilizing member is a unitary member and saidfirst and second pivotal couplings are fold lines.
 4. The immobilizingdevice of claim 2, wherein each of said arms include a coupling member,and said base includes at least one elongated slot, wherein saidcoupling members are received in said at least one elongated slot forsliding movement from a first position to a second folded uprightposition.
 5. The immobilizing device of claim 2, wherein said couplingmembers are tabs coupled to said arms proximate said outer edges, saidtabs having a neck portion and a head portion, said head portion havinga width greater than a width of said at least one slot of said base forslidably coupling said tab to said base.
 6. The immobilizing device ofclaim 5, further comprising a bottom panel coupled to a bottom side ofsaid base, said bottom panel having at least one elongated slotsuperimposed with said at least one slot of said base, said at least oneslot in said bottom panel having a width at least as great as the widthof said head portion of said tabs.
 7. The immobilizing device of claim6, wherein said head portion of said tabs have a substantiallytrapezoidal shape, and wherein said at least one slot in said bottompanel include a plurality of inwardly directed ratcheting teeth forinterlocking with said head of said tabs and resisting sliding movementof said tab in said slots in a direction away from said center panel. 8.The immobilizing device of claim 5, wherein said actuating device is aflexible member coupled to each of said tabs for simultaneously slidingsaid arms to said second folded position.
 9. The immobilizing device ofclaim 8, further comprising a guide member positioned on a bottom faceof said base for guiding said actuating device.
 10. The immobilizingdevice of claim 9, wherein said guide member has a first endsubstantially aligned inwardly with respect to said tabs, an elongatedslot extending inwardly from said first end toward a second end of saidguide member, wherein said actuating member passes through said slotfrom said first end to said second end, whereby pulling said actuatingmember through said slot pulls the ends of said arms toward said centerpanel to said folded position.
 11. The immobilizing device of claim 10,wherein said actuating member includes a body portion having a pluralityof teeth and a pair of flexible legs, each of said legs being coupled toa respective arm of said immobilizing member, and wherein saidimmobilizing device includes an aperture, and said body portion of saidactuating member passing through said aperture whereby said teeth ofsaid body portion engage a side wall of said aperture to lock saidactuating member in a fixed position.
 12. The immobilizing device ofclaim 5, wherein said actuating device is a flexible cord.
 13. Theimmobilizing device of claim 1, further comprising a locking device forlocking the position of said actuating device.
 14. The immobilizingdevice of claim 1, wherein said center panel includes an aperture, saidaperture having opposing side walls forming a guiding device for guidingsaid actuating device.
 15. The immobilizing device of claim 1, furthercomprising an adhesive covering a portion of a bottom surface of saidbase, and a release liner covering said adhesive, said release linerhaving a length greater than a length of said adhesive to form an endtab, said end tab being folded along an angle with respect to alongitudinal dimension of said release liner and having a length toextend beyond an outer edge of said base.
 16. A cervical immobilizingdevice, comprising a base having first and second ends, a front edge anda rear edge, said base having a first longitudinal slot extending fromsaid first end toward a center portion of said base and a secondlongitudinal slot extending from said second end toward said centerportion of said base; a cervical immobilizing member having a centerpanel attached to said center portion of said base, a first arm havingan inner end coupled to a first edge of said center panel and an outerend spaced from said inner end, and a second arm having an inner endcoupled to a second side of said center panel and an outer end spacedfrom said inner end, said first arm having a first coupling member forsliding engagement with said first slot and for coupling said first armto said base, and said second arm having a second coupling member forsliding engagement with said second slot and for coupling said secondarm to said base, said first and second arms being foldable from a firstsubstantially flat position to a second folded, upright position; alocking device for locking said first and second arms in said folded,upright position; an actuating device coupled to said first and secondarms for simultaneously and substantially symmetrically sliding saidouter ends of said first and second arms inwardly toward said centerpanel to fold each of said arms to said second folded upright positionhaving a substantially inverted V-shaped configuration to engage andsupport a patient's head; and a guide member positioned on a bottom faceof said base for guiding said actuating device and having a first endsubstantially aligned inwardly with respect to said tabs, an elongatedslot having guiding surfaces extending inwardly from said first endtoward a second end of said guide member, wherein said actuating memberpasses through said slot from said first end to said second end, wherebypulling said actuating device through said slot pulls the ends of saidarms toward said center panel to said folded position.
 17. A cervicalimmobilizing device, comprising a base having first and second ends, afront edge and a rear edge, said base having a first longitudinal slotextending from said first end toward a center portion of said base and asecond longitudinal slot extending from said second end toward saidcenter portion of said base; a cervical immobilizing member having acenter panel attached to said center portion of said base, a first armhaving an inner end coupled to a first edge of said center panel and anouter end spaced from said inner end, and a second arm having an innerend coupled to a second side of said center panel and an outer endspaced from said inner end, said first arm having a first couplingmember for sliding engagement with said first slot and for coupling saidfirst arm to said base, and said second arm having a second couplingmember for sliding engagement with said second slot and for couplingsaid second arm to said base, said first and second arms being foldablefrom a first substantially flat position to a second folded, uprightposition; a locking device for locking said first and second arms insaid folded, upright position; and an actuating device coupled to saidfirst and second arms for simultaneously and substantially symmetricallysliding said outer ends of said first and second arms inwardly towardsaid center panel to fold each of said arms to said second foldedupright position having a substantially inverted V-shaped configurationto engage and support a patient's head; wherein said actuating memberincludes a body portion having a plurality of teeth and a pair offlexible legs, each of said legs being coupled to a respective arm ofsaid immobilizing member, and wherein said immobilizing device includesan aperture, said body portion of said actuating member passing throughsaid aperture whereby the teeth of said body portion engage a side wallof said aperture to lock said actuating member and lock said arms insaid folded position.
 18. A cervical immobilizing device, comprising abase having first and second ends, a front edge and a rear edge, saidbase having a first longitudinal slot extending from said first endtoward a center portion of said base and a second longitudinal slotextending from said second end toward said center portion of said base;a cervical immobilizing member having a center panel attached to saidcenter portion of said base, a first arm having an inner end coupled toa first edge of said center panel and an outer end spaced from saidinner end, and a second arm having an inner end coupled to a second sideof said center panel and an outer end spaced from said inner end, saidfirst arm having a first coupling member for sliding engagement withsaid first slot and for coupling said first arm to said base, and saidsecond arm having a second coupling member for sliding engagement withsaid second slot and for coupling said second arm to said base, saidfirst and second arms being foldable from a first substantially flatposition to a second folded, upright position; and a locking device forlocking said first and second arms in said folded, upright position;wherein said coupling members of said first and second coupling membersinclude a neck portion, and a head portion having a substantiallytrapezoidal shape, and wherein said slots in said base include aplurality of inwardly directed ratcheting teeth for interlocking withsaid head of said coupling member and limiting sliding movement of saidcoupling members in said slots.